It’s a bizarre condition that causes women to have up to 100 orgasms a day and has mystified doctors for years.
But now doctors say they may know the cause of persistent genital arousal disorder (PGAD), after studying 10 patients.
Medical scans suggested their constant state of arousal was caused by lesions – injuries or growths – on spinal nerves that control sexual arousal.
Nine out of the 10 participants had unusual findings on their spine, such as cysts, and two of them were completely cured of the PGAD when these were treated.
Another six had their symptoms eased through similar procedures, doctors said.
PGAD leads to constant feeling of physical sexual arousal – but the sufferer does not feel any sexual desire. It is unclear how many women are affected.
Treatments vary from gels to masturbation and even counselling to try and identify triggers. But patients, who are mainly women, can go years without finding relief.
A condition that causes women to have up to 100 orgasms a day may be caused by lesions on nerves in the spine that control sexual arousal, a review of evidence has found
Harvard Medical School experts reviewed 10 women who had episodes of uncontrollable arousal lasting minutes to hours, which even occurred during sleep.
The study, led by Dr Saurabh Sharma, provides clues for effective treatment moving forward.
She said doctors should always consider nerve damage or similar problems before offering psychiatric therapy to PGAD patients.
All the women reported ‘out-of-context sexual arousal and/or orgasm’, according to the findings published in the journal PAIN Reports.
The symptoms – which started in one patient when she was just 11 – include swelling of the vagina, tingling and a feeling of pressure.
Episodes of sexual arousal do not always result in orgasm. But eight women reported having more than 30 episodes a day, most of which did include orgasm.
None had any relief from drugs, injections, Botox, therapy or nerve blockers. Some even reported treatment making their symptoms worse.
Nearly all tried masturbation to end the episodes. Despite not being pleasurable, the climax blunted their sexual arousal for a few hours.
WHAT IS PERSISTENT GENITAL AROUSAL DISORDER?
Persistent genital arousal disorder (PGAD) is a condition in which someone cannot control their physical sexual arousal and has orgasms at random.
The condition is not sexual or linked to desire and can be debilitating and painful for those who suffer from it.
Doctors don’t know how many people have the condition, but it is believed to be significantly more common among women and is estimated to affect as many as one per cent of females.
Signs of the condition may include wetness in the vagina, itching, the feeling of pressure, burning, pounding, or pins and needles.
Some describe it as feeling congested.
PGAD’s causes aren’t well understood but it could be triggered by stress, certain medications, nerve damage or certain types of cysts called Tarlov cysts.
Treatment may involve behavioural therapy, painkillers or in some cases medication, but the condition is not curable.
Source: Medical News Today
Nine women had symptoms such as pain or numbness in the pelvis, buttocks, leg or back. This suggested nerve problems.
The volunteers had been through rigorous testing including MRI scans which tried to identify the root cause of their PGAD.
Nine out of 10 patients had lesions on or problems with the lower spinal cord or nerves that control sexual arousal and orgasm.
For example, the dorsal nerve, which has roots in the spinal cord and travels to the genitals, largely induces sensation to the clitoris or penis.
Anything which puts pressure on a nerve or interrupts the flow of electrical signals can cause unwanted effects by triggering uncontrollable signals to and from the brain.
Tarlov cysts, most commonly found at the base of the spine around the nerve roots, were the most common problem found in the study.
The fluid-filled lumps can damage nerves by putting pressure on them, affecting sexual, bladder and bowel function.
Two women had sensory polyneuropathy, which is when multiple nerves involved in sensation and touch become damaged and can’t communicate messages to the brain properly.
One had spina bifida occulta, a malformation and gap in the spine which leaves the spinal cord vulnerable to injury.
Another woman had a suspected herniated disk in the lower spine, known to cause numbness or tingling in legs and feet.
Around half the patients had significant improvement in their PGAD symptoms with ‘neurological treatments’.
By relieving pressure on nerves or getting rid of abnormalities which stop them working normally, the researchers suggest sufferers’ impulses to and from the brain could be controlled, stopping them getting constantly aroused for no reason.
One patient was totally cured of PGAD by surgery to remove Tarlov cysts in the sacral region – the lower spine and pelvis.
Another woman in the study was cured by coming off antidepressants over a three-week period.
The relationship between PGAD and depression and anxiety remains unclear. In this case, the woman’s PGAD was cured after she reduced her medication.
Antidepressants has typically eased symptoms of PGAD. And the patient found if she completely stopped her medication, her PGAD came back.
Sometimes counselling, therapy or CBT has been shown to relieve symptoms if anxiety or depression is a key driver.
But these had failed to help the women in the study, one of whom said she had been hospitalised in a mental health hospital many times.